R. NICKBRYANMDS. JAMESZINREICHMD
The MRI scans (Figure 1 and Figure 2) demonstrated a gadolinium-enhanced mass lesion involving the frontal, ethmoidal, and anterior sphenoidal sinuses. The mass produced significant mass effect of the orbit on the axial MRI and CT studies (Figure 1 and Figure 3). On the CT image, the bone appeared to be remodeled and the lesion was sharply demarcated. Also, on the CT image, there was increased bony density along the perimeter of the expansile lesion, a finding that is associated with a chronic inflammatory process. In this case, the enhancement that was seen on both MRI and CT studies may have been related to some superinfection of the mucocele. Other considerations included osteoblastoma, an unusual tumor noted adjacent or within the calvarium, which is much more common in the spine, or hemangioma of the skull, which would have characteristics of a more vascular lesion on MRI scans.
Imaging Quiz Case 1. Arch Otolaryngol Head Neck Surg. 1998;124(9):1048. doi:10.1001/archotol.124.9.1046